Chest
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Meta Analysis
Bronchoprotective effects of leukotriene receptor antagonists in asthma: a meta-analysis.
Cysteinyl leukotrienes are important proinflammatory mediators in the pathogenesis of asthma. Since bronchial hyperresponsiveness is a noninvasive surrogate marker of asthmatic airway inflammation, we evaluated the bronchoprotection afforded by leukotriene receptor antagonists (LTRAs). ⋯ Since the estimated protection amounted to almost one doubling dose, this reinforces the role of LTRAs as anti-inflammatory therapy in asthma.
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The incidence of aortic dissection ranges from 5 to 30 cases per million people per year, depending on the prevalence of risk factors in the study population. Although the disease is uncommon, its outcome is frequently fatal, and many patients with aortic dissection die before presentation to the hospital or prior to diagnosis. While pain is the most common symptom of aortic dissection, more than one-third of patients may develop a myriad of symptoms secondary to the involvement of the organ systems. ⋯ Recently, endovascular stent placement has been used for the treatment of aortic dissection in select patient populations, but the experience is limited. The technique could be an option for patients who are poor surgical candidates, or in whom the risk of complications is gravely high, especially so in the patients with distal dissections. The clinical, diagnostic, and management perspectives on aortic dissection and its variants, aortic intramural hematoma and atherosclerotic aortic ulcer, are reviewed.
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Comparative Study Clinical Trial
Effects of nasal pressure support on ventilation and inspiratory work in normocapnic and hypercapnic patients with stable COPD.
To assess and compare the effect of nasal continuous positive airway pressure (nCPAP), inspiratory pressure support (PSV), and bilevel positive airway pressure (biPAP) on ventilatory parameters and inspiratory work (WOB) in normocapnic and hypercapnic patients with stable COPD. ⋯ The ventilatory response under nCPAP, PSV, and biPAP conditions is similar in hypercapnic and normocapnic patients with stable COPD; PSV and biPAP increase ventilatory parameters and improve Wdi. On the contrary, nCPAP improves WOB but does not increase ventilatory parameters.
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To determine the effect of sickle cell pain and its treatment on patients' breathing patterns, and to compare the effect of thoracic cage pain to pain at other sites. ⋯ Patients with VOC and chest pain have more shallow, rapid breathing than patients with pain elsewhere. Analgesia reduces these differences. As pain-associated shallow breathing and maldistribution of ventilation may contribute to the pathogenesis of acute chest syndrome, these results support the need for adequate pain relief and monitoring of ventilatory patterns during the treatment of VOC.
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Comparative Study
Outcomes for patients with sarcoidosis awaiting lung transplantation.
To describe the population of patients with sarcoidosis listed for orthotopic lung transplantation (OLT) in the United States, and to determine outcomes for these subjects relative to persons awaiting OLT for idiopathic pulmonary fibrosis (IPF). ⋯ Patients with sarcoidosis are at as high a risk for mortality as patients with IPF while awaiting transplantation. Nonetheless, patients with sarcoidosis are less likely to undergo OLT. Pulmonary hypertension is a major concern in patients with advanced sarcoidosis awaiting transplantation.